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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6918 <br />MAIN ST & 15TH ST TRAFFIC SIGNAL INSTALLATION <br />FEDERAL PROJECT NO: HSIPL 5063 (189) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />Complete this form to d[sclose lobbying activities purs am to 31 ILS.C. 1352 <br />f5 revarsa f r m,N:n h.m— A:crL.c— <br />1.Typeo ederaf Action: <br />2- Status of Federal Potion:-��_--3-Report <br />Type: <br />ct <br />Llb. bidinitll ffr,award5liraaor <br />initial <br />b. grant <br />b. materia. <br />al Range <br />c, coopera agreement <br />C. post -award <br />For Material Change Only <br />d- ban <br />year qu <br />e- ban guarani <br />dale of last report <br />f. loan inwmrae <br />4. Name and Address offteparting Entity: <br />5- N Reporting Entity in No. 4 is a Suba rdee, Entr Name <br />El price ❑ 4 <br />and Address of Print: <br />Trer Kkfpown: <br />Congressional Distdat. fr4rmwn: <br />Conmessional District. mown: <br />6. Federal DepartmeMfAgen y,: <br />7. Federal Program N Description. <br />CFDA Number, T ficeble- <br />5. Federal Action Number, yafrawm: <br />19. cl Amo R rTMfrum: <br />S <br />1 O. a. Name and Address of Lobbybrg Entity b- IMiv s Performing Services (indoding addmns if <br />(ifinrTvidua1. fast name. festframe. M0: f Mo. rga ) <br />(! name tnarrre. 4N): <br />[aroar (:anMoran .Rr-IlLA, lfnc� <br />f 1. Amount of Payment (check aJJ that apply): <br />13. Type of Payment (the a4 dwt afWYY <br />S ❑ act ua ❑ pavrr <br />❑ a rutrwx <br />❑ 6alnLnalYa <br />Elc conversion <br />12- Form of Payment (chock all Nat appryk <br />❑ a own <br />❑ daarrhrgrdar <br />❑ a. imam "dly: names, <br />❑ a. d,furad <br />value <br />❑ r. obrrr. sp"W: <br />14. Brief Description of Services rmed rrr to be Performed and Dates) of Service, inducting <br />empioyee(s), or Nerrrbef(s) faetM, for Payment Indicated in tlean 7f: <br />afbm CarNnadmn 9rx a S.Fi[lA afrtvp <br />15. Continuation S s SF-LLI.A attached: YM <br />16.� ••+• 0.r,.....a.v.v,. a. ar uac r. <br />SignaWre- <br />,Y2 frY wsi. iugxe.nr �..V.Y w�bsrrf <br />.r•.,w.r.. n..pye.r a......sv.�e...nw <br />Name: J ht Wopg <br />Ttle: Vice P esi ent <br />.. �va.e�wa rmaa .a..�.v.�vmema <br />Telephone No.. 909- -5470 <br />p Da>e: l l/8/202] <br />Felt Use Only: <br />Aile4saprlaca RepgdNabn <br />Sdn4dm Fnrrrr 111 lily. ]+Y! <br />P-36 of P-52 <br />